Continuous Subcutaneous Insulin Infusion as an Effective Method of Desensitization Therapy for Diabetic Patients with Insulin Allergy: A 4-year Single-center Experience

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• 作者：Tao Yuan ; MD¹ ; Weigang Zhao ; MD¹ ; Lianglu Wang ; MD² ; Yingyue Dong ; BSN¹ ; Naishi Li ; MD ; PhD¹ ; ^{LNS@medmail.com.cn" class="auth_mail" title="E-mail the corresponding author}
• 关键词：continuous subcutaneous insulin infusion ; desensitization ; insulin allergy ; diabetes mellitus ; multiple dosage injection
• 刊名：Clinical Therapeutics
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：38
• 期：11
• 页码：2489-2494.e1
• 全文大小：340 K

文摘

This article summarizes our experiences in the application of continuous subcutaneous insulin infusion (CSII) as a method of rapid desensitization therapy for diabetic patients with insulin allergy that was subsequently switched to a regimen of multiple-dose injections for long-term insulin therapy.

Methods

The clinical data of 11 diabetic patients with insulin allergy in Peking Union Medical College Hospital from April 1, 2008, through December 31, 2011, were retrospectively analyzed.

Findings

All 11 conditions were diagnosed by case history, skin testing, determination of serum specific anti-insulin IgE, and reaction to withdrawal of insulin. Seven patients accepted the traditional injection method of desensitization, and 5 patients accepted CSII with the protocol designed for this study (1 patient accepted CSII after failure by the formal method). Six of the 7 patients who accepted the traditional method and all 5 patients who accepted CSII had successful results. All 5 patients in the CSII group switched to a regimen of multiple dosage injections. In a survey of 28 nurses, both experienced nurses and practical nurses preferred to use CSII as the method of desensitization.

Implications

It is feasible and effective for diabetic patients with insulin allergy to use CSII as a method of rapid desensitization with subsequent switching to a regimen of multiple-dose injections for long-term insulin therapy.